TELEHEALTH NURSING FACT SHEET

TELEHEALTH NURSING FACT SHEETATA Telehealth Nursing SIGThe first publishedTelenursing article was byMary Quinn, RN in 1974.She described working in aBoston Hospitaltelemedicine Center andseeing patients remotelywho were at Logan Airport.Why Telehealth Nursing?• Decrease hospitaladmissions &emergencydepartment visits• Manage chronicillness• Impact nursingshortage byimproving nurseutilization• Reducehealthcare costs• Provide accessto careWhat is Telehealth Nursing?Any nurse who has spoken with a patient over the phone has practiced telehealth nursing; itis not a new role, although advances in technology allow nurses to see, monitor, and/orinteract remotely with patients/patient devices. Telehealth nursing is defined as “the use oftelehealth/telemedicine technology to deliver nursing care and conduct nursing practice.”Telenursing, telehealth nursing, nursing telepractice are interchangeable. Telehealth nursingis not a specialty area in nursing. Nurses in all settings who employ telecommunications andhealth technologies, such as, audio, video, or data integrated into their existing practice areproviding telehealth nursing. Combined with a body of knowledge and competencies used todeliver nursing care over distance telehealth nurses are successfully caring for patientsremotely.Who are Telehealth Nurses?In 2005, 719 telehealth nurses responded to an International Telenursing Survey. * The surveyreported Registered Nurses & Advanced Practice Nurses, who were fulltime or part‐time,work as telehealth nurses in the following regions:• 49 of 50 states in the U.S. (Delaware not represented)• 36 countries around the world [USA(68%); Canada (10%); Australia (5%); UK (4%);Norway (3.5%); New Zealand (1.1%); Sweden (1%); Iran (.6%); Finland (.6%); 3 countrieswith 3 telehealth nurses; 7 countries with 2 telehealth nurses; 17 countries with 1telehealth nurse]The exact number of global telenurses is unknown, however, ATA has over 500 telehealthnurse members. Other organizations that support telenurses are the International Council ofNursing Telenursing Network; International Society for Telemedicine and eHealth TelenursingWorking Group, and Canadian Telehealth Forum/COACH.*Grady, J.L, Schlachta‐Fairchild, L., & Elfrink, V. (2005). Results of the 2004‐2005 International Telenursing Survey. Telemedicineand e‐Health, 11 (2), 197.Where is Telehealth Nursing Practiced?Telehealth nursing is practiced in the home, healthcare clinic, doctor’s office, prisons,hospitals, telehealth nursing call centers and mobile units. Telephone triage, remotemonitoring and home care are the fastest growing applications. Home telehealth nurses usesystems that allow monitoring of patient data and physiologic parameters, such as, bloodpressure, heart sounds, blood glucose, oxygen levels, respiratory peak flow, and weightmeasurements via a phone or Internet connection. Through interactive video systems,patients contact on‐call nurses and arrange a live video consultation to address problems; forexample, how to change a dressing, give an insulin injection or to discuss increasing shortnessof breath. Telehealth nursing is also used by call centers operated by managed careorganizations, and staffed by RN case managers who conduct patient triage, education,counseling to regulate patient access/flow and decrease ER use. Telehealth nursing can alsoinvolve patient education, teleconsultations, conducting and communicating medicaltests/results conducting physicals exams/assessment and collaboration with healthcareproviders in implementing medical treatment protocols and providing follow‐up care.

Telehealth Nursing practiceareas include:• TeleICU• Teletriage• Teletrauma• Telestroke• Telepediatrics• Telemental Health• Telecardiology• Telehomecare• Telerehabilitation• ForensicTelenursing, etc.Contact:American TelemedicineAssociation1100 Connecticut Ave,NWSuite 540Washington, DC 20036Phone: 202‐223‐3333www.americantelemed.orgWhen is Telehealth Nursing used?Telehealth nursing is employed when there is a need to deliver nursing care remotely andimprove efficiency and access to healthcare. A nurse can telepresent a patient to a remotephysician, nurse practitioner, or physician assistant for assessment, evaluation and treatmentfor emergent and non emergent consultations, routine pre and post care as well as forensicabuse cases. Telehealth nurses deliver nursing care remotely, and are also creators,educators, designers, developers, implementers, and researchers of telehealth and ehealthservices.How does Telehealth Nursing work?Telehealth nursing is a set of competencies for any nurse to utilize and are defined by the ICN.Certification is not required or recommended at this time. General information forimplementing, planning or conducting any type of telehealth program can be found on theATA website.LicensureTelehealth nursing may require an additional licensure to practice across state lines.In non‐federal setting telehealth nurses must have a register nurse license that complies withboth state and federal regulations. In the US, the nurse licensure compact (NLC) allows RN’sto practice across compact members’ state lines.CompetenciesNurses must meet standards of care for safe, quality, and competent practice for telehealthnursing by practicing within the ANA scope and standards of nursing practice. Specifictelehealth standards can be found with the American Academy of Ambulatory Care Nurses(AAACN) and American Nurses Association (ANA.) International telenursing competencies areavailable from the International Council of Nursing (ICN), which has rigorously reviewed andapproved a 39 page competencies document. ICN competencies apply to nurses in the USA,Canada, and over 130 countries globally.LegalPatient confidentiality and HIPAA requirements apply to telehealth nursing. Privacy policiesand informed patient consent remain the same for telehealth encounters as for in‐personcare.FutureAs the US healthcare environment continues to evolve due to changes in reimbursement,legal issues, and shrinking healthcare resources, the expanding role of telehealth nurses willcontinue to evolve. Leadership and collaboration among international nurses is needed tooutline the uses of ehealth/telehealth technologies to provide nursing care in aninterdisciplinary manner to patients, regardless of staffing, time, or geographic boundaries.Complete ReferencesFor complete references go to the ATA website at americantelemed.org/telehealthnursing,scroll down to “Products and Resources.”More info ‐ Web Linkswww.ncsbn.org/nlc.htmwww.icn.ch/telenursing_network.htmwww.isft.net/cms/index.php?telenursingApril 2011